QualCode, Inc.

Start your year off right by diving into the latest insights, updates, and innovations in our January 2025 InfoCode Newsletter! qualcodeinc.com/infocode/newsl… #qualcodeinc #newsletter #revenuecyclemanagement #medicare #healthcare #NYC #codingexperts #healthcareupdates #medicalcoding

🚨 The Centers for Medicare & Medicaid Services (CMS) have proposed new rules for Contract Year 2026. CMS is accepting public comments until January 27, 2025. #medicaid #CMS #medicare2026 #medicalcoding #revenuecyclemanagement #qualcodeinc

Maximize Reimbursements with Accurate HCC Risk Adjustment Validation! Ensuring precise HCC (Hierarchical Condition Category) Risk Adjustment Validation is crucial for capturing the full complexity of patient care and securing proper reimbursements. #HCCValidation #medicalcoding

Join our team at QualCode, Inc.! We're seeking experienced Full-Time DRG Validators to work remotely. Visit our careers page and email us directly at info@qualcodeinc.com

HHS releases information blocking rule related to care access. federalregister.gov/documents/2024… #hhs #healthdata #interoperability #informationblocking #qualcodeinc

AHIMA publishes new issue brief on transitioning to electronic prior authorization. ahima.org/media/rdaamo3c… #ahima #priorauthorization #revenuecyclemanagement #qualcodeinc

Happy Holidays from the QualCode Team!🎄 May your holiday season be filled with joy, love, and cherished moments with family and friends. Here's to a bright and successful new year ahead! Warmest wishes, Natalie Williams President & CEO, QualCode #happyholidays #qualcodeinc

New CMS framework seeks to optimize care delivery by reducing administrative burden. cms.gov/priorities/key… #cms #medicare #revenuecyclemanagement #qualcodeinc

In FY 2023, civil health care fraud settlements and judgments under the False Claims Act exceeded $1.8 billion. oig.hhs.gov/reports/all/20… #oig #hhs #healthcarefraud #falseclaimsact #qualcodeinc

In FY 2024, the Medicare Fee-for-Service (FFS) estimated improper payment rate was 7.66%, or $31.7 billion. cms.gov/newsroom/fact-… #cms #medicare #hhs #healthcare #revenuecyclemanagement #qualcodeinc

Be sure to check out the 2024 Health and Human Services (HHS) Agency Financial Report which provides an overview of the Department's financial status, performance results, and key initiatives. hhs.gov/sites/default/… #hhs #medicare #revenuecyclemanagement #qualcodeinc #cms

The December Edition of the InfoCode Newsletter is Here! What’s inside? ✅ Industry trends for 2024 ✅ Tips to optimize your coding ✅ Inspiring success stories ✅ And much more! Check out the highlights here: qualcodeinc.com/infocode/newsl… #qualcodeinc #newsletter #medicalcoding

New proposed rule would make Medicare Advantage plans’ prior authorization rules and coverage criteria publicly available. public-inspection.federalregister.gov/2024-27939.pdf #cms #medicare #medicareadvantage #priorauthorization #revenuecyclemanagement #qualcodeinc

Medicare may cover new weight loss medications for obesity, but proposed rule must be finalized first. statnews.com/2024/11/26/whi… #medicare #glp1 #wegovy #zepbound

Revenue improvements in 2024 were offset by higher denial rates: · Increase in coding-related denials of more than 125% · Increase in outpatient medical necessity-related denials of 75% · Increase in patient medical necessity denials 140% mdaudit.com/resource/repor… #qualcodeinc

Hospitals that collect health-related social needs data in a structured format can use it more easily for population health analytics and referrals for social services. healthit.gov/buzz-blog/heal… #hrsn #sdoh #populationhealth #medicalcoding #revenuecyclemanagement #qualcodeinc

The percentage of hospitals in full compliance with federal price transparency rules fell from February to November, from 34.5% to 21.1%, according to a new report. patientrightsadvocate.org/seventh-semi-a… #pricetransparency #nosurprisesact #revenuecyclemanagment #qualcodeinc

Almost a quarter of Americans are underinsured, according to a recent survey. commonwealthfund.org/publications/s… #commonwealthfund #healthcare #qualcodeinc

$190 million. That’s the amount Medicare improperly paid acute care hospitals over 5 years for outpatient services provided to hospice enrollees. oig.hhs.gov/reports/all/20… #oig #hhs #medicare #revenuecyclemanagement #qualcodeinc

Effective January 1, 2025, hospitals are required to use the new Notice of Medicare Non-Coverage and Detailed Explanation of Non-Coverage. cms.gov/medicare/forms… #nomnc #denc #medicare #revenuecyclemanagement #qualcodeinc